scholarly journals Sensitivity of hemodynamic parameters obtained by conventional duplex scanner in the evaluation of extracranial carotid disease severity

2003 ◽  
Vol 60 (4) ◽  
pp. 435-442
Author(s):  
Gordana Arandjelovic-Minic
Keyword(s):  
Spectral Analysis ◽  
Carotid Stenosis ◽  
Doppler Ultrasonography ◽  
Screening Method ◽  
Statistical Processing ◽  
Mean Value ◽  
Hemodynamic Parameter ◽  
Hemodynamic Parameters ◽  
Carotid Disease ◽  
Significant Independent Predictor

Progresson of extracranial carotid disease is considered to be significant independent predictor in the evaluation of individual cerebrovascular prognosis. Doppler ultrasonography is a useful screening method in the diagnosis and evaluation of extracranial carotid disease. The aim of this study was to establish the most sensitive hemodynamic parameter of Doppler-ultrasonographic spectral analysis in clinical evaluation of extracranial carotid disease. Investigation included 90 patients (of both sexes) in hospital and outpatient clinic care. Spectral analysis (M-scanning technique) was used for the evaluation of hemodynamic status of carotid sinus, including the following parameters: Pourcelot (A-D/A), Gosling (A/B) and Mol (A/D) resistance parameters. After statistical processing the results of the research affirmed hemodynamic parameters' values and correlation between Pourcelot hemodynamic parameter and the degree of carotid stenosis ?=0,59 for all patients, and ?=0,58 for patients with pathological values. Correlation between Mol parameter and the degree of carotid stenosis was ?=0,50 for all patients, and ?=0,57 for patients with pathological values. Gosling parameter was not significantly different in mean value and was present in all three groups. Functional relationship between the degree of carotid stenosis and each of hemodynamic parameters was established. It was concluded that Pourcelot and Mol parameters were significant indicators of asimptomatic carotid disease, but Pourcelot parameter was considered as a more sensitive indicator in the evaluation of extracranial carotid disease.

scholarly journals Ultrasonografic monitoring of hemodynamic parameters in symptomatic and asymptomatic patients with high-grade carotid stenosis prior and following carotid endarterectomy

2012 ◽  
Vol 69 (5) ◽  
pp. 399-404 ◽  
Author(s):  
Anka Mitrasinovic ◽  
Jovo Kolar ◽  
Sandra Radak ◽  
Dragoslav Nenezic ◽  
Ivana Kupresanin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Diagnostic Tool ◽  
Doppler Ultrasonography ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Hemodynamic Parameters ◽  
Diagnostic Modality ◽  
Asymptomatic Patients

Background/Aim. Doppler ultrasonography is now a reliable diagnostic tool for noninvasive examination of the morphology and hemodynamic parameters of extracranial segments of blood vessels that participate in the brain vascularisation. This diagnostic modality in recent years become the only diagnostic tool prior to surgery. The aim of the study was to determine hemodynamic status in symptomatic and asymtomatic patients with severe carotid stenosis prior to and after carotid endarterectomy (CEA). Methods. A total of 124 symptomatic and 94 asymptomatic patients who had underwent CEA at the Clinic for Cardiovasculare Disease ?Dedinje? in Belgrade were included in this study. Doppler ultrasonography examinations were performed one day before CEA and seven days after it. The peak systolic velocity (PSV), end-dyastolic velocity (EDV), time-averaged maximum blood flow velocity (MV), resistance index (RI) and the blood flow volume (BFV) of the ipsilateral and the contralateral internal carotid artery (ICA) were measured. Results. Diabetes was the only risk factor found significantly more frequent in symptomatic patients. There were significantly more occluded contralateral ICAs in the group of symptomatic patients. There was a significant increase in PSV, EDV, MV and BFV of the ipsilateral ICA after CEA and a significant decrease in PSV, EDV, MV and BFV of the contralateral ICA after CEA. RI is the only hemodynamic parameter without significant changes after CEA in both groups of patients. Comparing the values of hemodynamic parameters after CEA between the group of symptomatic and the group of asymptomatic patients no significant differences were found. Conclusion. The occlusion of the contralateral ICA is an important factor differentiating between symptomatic and asymptomatic patients with severe carotid stenosis. Successful surgery provides good recovery of cerebral hemodynamics in both symtomatic and asymptomatic patients.

scholarly journals Early Diagnosis of Carotid Stenosis by Ultrasound Doppler Investigations: A Classification Method for the Hemodynamic Parameter

Information ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 493
Author(s):  
Huiyue Xiao ◽  
Yi Zhang ◽  
Hao Yin ◽  
Paul Liu ◽  
Dong Chyuan Liu
Keyword(s):  
Cardiovascular Disease ◽  
Early Diagnosis ◽  
Carotid Stenosis ◽  
Diagnostic Method ◽  
Hemodynamic Parameter ◽  
Classification Method ◽  
Hemodynamic Parameters ◽  
Ultrasound Technique ◽  
Pulsed Wave Doppler ◽  
Expert Input

Pulsed Wave Doppler (PWD) is a traditional ultrasound technique used for the diagnosis of cardiovascular disease. The conventional diagnostic method is based on hemodynamic parameters obtained from the PW spectrum. However, it relies on the clinical experience of sonographers, and especially focusing on severe carotid stenosis. This paper proposes a classification method for the hemodynamic parameter using the RUSBoost algorithm. The proposed method improves the performance of RUSBoost by setting the empirical weight of each sample. The experimental results show that the proposed method reaches the accuracy of 90.1%, the sensitivity of 70%, and the specificity of 94%, which are 4%, 6%, and 2% higher than the original RUSBoost respectively. In addition, the proposed method is objective, since the empirical weights are computed based on Mahalanobis distance without any expert input. It can be used for the early detection of cardiovascular disease.

Baseline Cognitive Impairment in Patients With Asymptomatic Carotid Stenosis in the CREST-2 Trial

Stroke ◽  
2021 ◽  
Author(s):  
Ronald M. Lazar ◽  
Virginia G. Wadley ◽  
Terina Myers ◽  
Michael R. Jones ◽  
Donald V. Heck ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Carotid Stenosis ◽  
Racial Differences ◽  
Carotid Artery Disease ◽  
Word List ◽  
Population Based ◽  
Asymptomatic Carotid Stenosis ◽  
Carotid Disease ◽  
Asymptomatic Carotid ◽  
List Learning

Background and Purpose: Studies of carotid artery disease have suggested that high-grade stenosis can affect cognition, even without stroke. The presence and degree of cognitive impairment in such patients have not been reported and compared with a demographically matched population-based cohort. Methods: We studied cognition in 1000 consecutive CREST-2 (Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial) patients, a treatment trial for asymptomatic carotid disease. Cognitive assessment was after randomization but before assigned treatment. The cognitive battery was developed in the general population REGARDS Study (Reasons for Geographic and Racial Differences in Stroke), involving Word List Learning Sum, Word List Recall, and Word List fluency for animal names and the letter F. The carotid stenosis patients were >45 years old with ≥70% asymptomatic carotid stenosis and no history of prevalent stroke. The distribution of cognitive performance for the patients was standardized, accounting for age, race, and education using performance from REGARDS, and after further adjustment for hypertension, diabetes, dyslipidemia, and smoking. Using the Wald Test, we tabulated the proportion of Z scores less than the anticipated deviate for the population-based cohort for representative percentiles. Results: There were 786 baseline assessments. Mean age was 70 years, 58% men, and 52% right-sided stenosis. The overall Z score for patients was significantly below expected for higher percentiles ( P <0.0001 for 50th, 75th, and 95th percentiles) and marginally below expected for the 25th percentile ( P =0.015). Lower performance was attributed largely to Word List Recall ( P <0.0001 for all percentiles) and for Word List Learning (50th, 75th, and 95th percentiles below expected, P ≤0.01). The scores for left versus right carotid disease were similar. Conclusions: Baseline cognition of patients with severe carotid stenosis showed below normal cognition compared to the population-based cohort, controlling for demographic and cardiovascular risk factors. This cohort represents the largest group to date to demonstrate that poorer cognition, especially memory, in this disease. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02089217.

Carotid artery stenosis

2018 ◽  
pp. 453-460
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Scoring System ◽  
Ultrasound Scan ◽  
Amaurosis Fugax ◽  
Carotid Ultrasound ◽  
Carotid Disease ◽  
Asymptomatic Carotid ◽  
Transient Ischaemic Attacks

Carotid disease is often asymptomatic but can lead to strokes, transient ischaemic attacks (TIA), or amaurosis fugax. This chapter explores the pathogenesis of the disease and examines the investigations often used to diagnose the severity of the carotid stenosis. It details the ABCD scoring system for TIA evaluation and the features in the carotid ultrasound scan that are used to establish the degree of stenosis. A recommended approach to managing symptomatic and asymptomatic carotid disease is described.

scholarly journals Pulse Pressure Variation Can Predict the Hemodynamic Response to Pneumoperitoneum in Dogs: A Retrospective Study

2019 ◽  
Vol 6 (1) ◽  
pp. 17
Author(s):  
Caterina Di Bella ◽  
Luca Lacitignola ◽  
Laura Fracassi ◽  
Despoina Skouropoulou ◽  
Antonio Crovace ◽  
...  
Keyword(s):  
Pulse Pressure ◽  
Roc Curve ◽  
Pulse Pressure Variation ◽  
Healthy Subjects ◽  
Hemodynamic Response ◽  
Hemodynamic Parameter ◽  
Pressure Variation ◽  
Hemodynamic Parameters ◽  
Group Data ◽  
Valid Predictor

Pneumoperitoneum may induce important hemodynamic alterations in healthy subjects. Pulse pressure variation (PPV) is a hemodynamic parameter able to discriminate preload dependent subjects. Anesthesia records of dogs undergoing laparoscopy were retrospectively evaluated. The anesthetic protocol included acepromazine, methadone, propofol and isoflurane administered with oxygen under mechanical ventilation. The hemodynamic parameters were considered five minutes before (BASE) and ten minutes after (P10) the pneumoperitoneum. Based on the cardiac index (CI) variation, at P10, dogs were classified as sensitive (S group, CI ≤ 15%) and non-sensitive (NO-S group). Data were analyzed with the ANOVA test and the ROC curve (p < 0.05). Fifty-five percent of dogs (S) had a reduction of CI ≥ 15% at P10 (2.97 ± 1.4 L/min/m2) compared to BASE (4.32 ± 1.62 L/min/m2) and at P10 in the NO-S group (4.51 ± 1.41 L/min/m2). PPV at BASE was significantly higher in the S group (22.4% ± 6.1%) compared to the NO-S group (10.9% ± 3.3%). The ROC curve showed a threshold of PPV > 16% to distinguish the S and NO-S groups. PPV may be a valid predictor of the hemodynamic response to pneumoperitoneum in dogs. A PPV > 16% can identify patients that may require fluid administration before the creation of pneumoperitoneum.

scholarly journals LO012: High-risk investigation findings for symptomatic carotid disease in ED TIA patients

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S34-S34
Author(s):  
N. Motamedi ◽  
K. Abdulaziz ◽  
M. Sharma ◽  
J.J. Perry
Keyword(s):  
Platelet Count ◽  
Blood Glucose ◽  
High Risk ◽  
Carotid Stenosis ◽  
Univariate Analysis ◽  
Carotid Disease ◽  
Multicenter Cohort Study ◽  
Symptomatic Carotid ◽  
Acute Infarction ◽  
Large Vessel Disease

Introduction: About 20% of TIAs are due to large vessel disease. Carotid stenosis >50% which is causing a TIA or stroke needs to be definitely managed quickly in order to benefit. Alternatively, dual antiplatelet therapy may be considered. The objective of this study was to determine high-risk diagnostic findings associated with symptomatic carotid disease in ED patients with TIA to indicate patients requiring urgent carotid imaging. Methods: We performed a prospective Canadian multicenter cohort study, at 13 academic sites, of ED patients with TIA or non-disabling stroke from 2006-2014. Study research nurses recorded imaging findings on standardized data collection forms from the final reports of all imaging tests ordered in the ED on prospectively enrolled patients by treating emergency physicians. Symptomatic carotid disease was defined as carotid stenosis 50-99% or carotid dissection and was adjudicated by stroke neurology to be the etiology of the index event. Patients were followed by medical review and telephone up to 90 days. Univariate analysis was conducted for investigation results with our primary outcome. Results: The cohort included 305 patients with and 5,277 without symptomatic carotid disease. Positive predictors of symptomatic carotid disease included platelet count over 400 x 109/L (15.3% vs 7.6%; p=0.0095), blood glucose >15 mmol/L (11.4% vs 4.4%; p<0.0001), CT evidence of acute infarction (9.8% vs 4.1%; p<0.0001), CT evidence of old infarction (35.7% vs 24.1%; p<0.0001), and CT evidence of any infarct (43.3% vs 26.7%; p<0.0001). There were no negative predictors of symptomatic carotid disease. Conclusion: High-risk investigation findings suggestive of symptomatic carotid disease in ED TIA patients include platelet count over 400 x 109/L, blood glucose >15 mmol/L, CT evidence of any infarction. Patients with any of these findings should be considered for rapid carotid imaging.

scholarly journals Transcranial Doppler ultrasonography as a predictor of haemodynamically significant carotid stenosis

1999 ◽  
Vol 86 (5) ◽  
pp. 692-693 ◽  
Author(s):  
S. Byrd ◽  
J. Wolfe ◽  
A. Nicolaides ◽  
G. Stansby ◽  
N. Cheshire ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Transcranial Doppler ◽  
Doppler Ultrasonography ◽  
Transcranial Doppler Ultrasonography

Variability and habituation of nystagmic responses to hot caloric stimulation of normal subjects

1982 ◽  
Vol 96 (7) ◽  
pp. 599-612 ◽  
Author(s):  
P. G. Davey ◽  
E. S. Harpur ◽  
F. Jabeen ◽  
D. Shannon ◽  
P. M. Shenoi
Keyword(s):  
Phase Velocity ◽  
Screening Method ◽  
Normal Subjects ◽  
Mean Value ◽  
Slow Phase ◽  
Caloric Test ◽  
Maximum Frequency ◽  
Slow Phase Velocity ◽  
Caloric Stimulation ◽  
Vestibular Toxicity

AbstractExperiments were performed on 25 otoneurologically ‘normal’ subjects to evaluate the hot caloric test as a screening test for aminoglycoside vestibular toxicity.Using portable equipment under non-ideal conditions, it was found that there was a large inter-subject variability in nystagmic response and that, instead of a random test-retest variability, a systagmic variation in response occurred on repeated caloric stimulation with water at 44°C.A response deline (habituation) evident in both the maximum slow phase velocity and the maximum frequency occurred at second test, although the inter-test interval ranged from 24 to 72 hours.After a 3-month interval with no intervening tests, the mean value of the maximum frequency reverted back to the original level. However, there was still a significant reduction in maximum slow phase velocity at this time. Some individuals had a sustanined reduction in both parameters.Hence it is concluded that the hot caloric test, used under the conditions described in this study, is not a suitable serial screening method for aminoglycoside vestibular toxicity. The reproducibility of this test under other conditions, or any other caloric test, should be established in normal subjects befre employing, it as a serial screen for aminoglycoside vestibular toxicity.

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